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Advances in Therapy
Article . 2023 . Peer-reviewed
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The Frozen Elephant Technique Using a Novel Hybrid Prosthesis for Extensive Aortic Arch Disease: A Multicentre Study

Authors: El-Sayed Ahmad, Ali; Silaschi, Miriam; Borger, Michael; Seidiramool, Vahid; Hamiko, Marwan; Leontyev, Sergey; Zierer, Andreas; +5 Authors

The Frozen Elephant Technique Using a Novel Hybrid Prosthesis for Extensive Aortic Arch Disease: A Multicentre Study

Abstract

The frozen elephant trunk technique (FET) has become routine for aortic arch and descending aortic repair. New hybrid prosthesis models are constantly being developed to increase effectiveness and durability of aortic repair. Recently, concerns were raised regarding increased post-operative bleeding using a new-generation hybrid prosthesis (E-vita® OPEN NEO, CryoLife Inc. JOTEC GmbH, Hechingen, Germany). We report the outcomes of a multi-centre experience of using the E-vita OPEN NEO.All patients undergoing aortic surgery at five European centres using the E-vita OPEN NEO from 2020 to 2022 were included (n = 22). The primary endpoint was the amount of chest drain fluid after 24 h and re-thoracotomy rate for bleeding.Median patient age was 62.5 ± 12.6 years, 50.0% (11/22 patients) were female and 27.3% (6/22) of procedures were re-operative cardiac surgeries. Aortic dissection was present in 54.5% (12/22). The median cardiopulmonary bypass time was 148 min and ischaemia time was 84 min. Mortality at 30 days was 4.5% (1/22) and the stroke rate was 18.2% (4/22). The rate of re-thoracotomy for bleeding was 4.5% (1/22) with a median amount of chest drain fluid within 24 h of 569 (IQR 338-910) ml. There were no device-associated adverse events.Use of this new-generation hybrid prosthesis for FET was safe and effective. Patient follow-up was largely uneventful given the extent of the procedures performed. In particular, bleeding events were uncommon in this cohort of patients comprising many aortic dissections and re-operative procedures. No increase in oozing was observed.

Keywords

Male, Female [MeSH] ; Aged [MeSH] ; Aortic Dissection/surgery [MeSH] ; Humans [MeSH] ; Treatment Outcome [MeSH] ; Aortic surgery ; Retrospective Studies [MeSH] ; Middle Aged [MeSH] ; Blood Vessel Prosthesis Implantation/adverse effects [MeSH] ; Aorta, Thoracic/surgery [MeSH] ; Frozen elephant trunk ; Blood Vessel Prosthesis [MeSH] ; Male [MeSH] ; Hybrid aortic repair ; Aorta, Thoracic/diagnostic imaging [MeSH] ; Original Research ; Aortic prosthesis ; Blood Vessel Prosthesis Implantation/methods [MeSH], Aorta, Thoracic, Middle Aged, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Aortic Dissection, Treatment Outcome, Humans, Female, Original Research, Aged, Retrospective Studies

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    popularity
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    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
7
Top 10%
Average
Top 10%
Green
hybrid